Compliance Analyst

2 weeks ago

San Jose, United States Santa Clara Family Health Plan Full time

**About Us**:
Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to improving the health and well-being of the residents of Santa Clara County. Working in partnership with providers and community organizations, we serve our neighbors through our Medi-Cal and SCFHP DualConnect (HMO D-SNP) health care plans.

**About the role**:
The Compliance Analyst researches, plans, implements, and monitors a broad portfolio of compliance programs and initiatives to enable organizational compliance with all applicable Federal, state, and local regulations/laws. On an on-going basis, researches and interprets regulations and laws to establish compliance standards, and may develop and/or deliver training and/or communications relative to new standards. May be responsible for project management relative to new compliance initiatives, products, or annual processes

**Day to Day**:

- Implement, support and enforce SCFHP’s Privacy Program; assist in updates and revisions to the Privacy Program as needed or required by law to ensure SCFHP's compliance with state, federal and international privacy laws; implement, support, and enforce best practices to protect the privacy of members' protected health information (PHI).
- Build strong relationships and collaborate with business units to promote the Privacy Program and encourage privacy compliance at all levels of the organization
- Assist as requested in the timely creation, review, revision and updates to privacy policies, desk level procedures, resource guides, job aides and other educational tools
- Act as a liaison with regulatory enforcement agencies; cooperate and participate as required by technical assistance letters, investigations, compliance reviews, audits and other reviews made by regulatory agencies, including CMS, OCR, DMHC, and DHCS.
- Provides project management, coordination, and analytical support for compliance projects. Provides consultation on internal and external requirements. Evaluates regulatory requirements and potential operational impacts.
- Assists in the identification of compliance program needs, and develops strategies, plans, and documentation for programs and related initiatives.
- Supports the Manager, Compliance (Medi-Cal/Medicare) by designing, documenting and implementing process improvement initiatives within the department.
- Supports and when directed, leads the Compliance Work Group and other cross-functional work groups.
- Assists in leading the development and maintenance of health plan FWA program capabilities and offerings.
- Supports compliance audits, risk assessments and ongoing compliance monitoring activities, including the coordination of data requests.

**About You**:

- Bachelor’s Degree in Business, Healthcare Administration or a related field or equivalent experience, training or coursework.
- Minimum 3 years progressively responsible compliance experience in a healthcare or managed care environment. A Master’s Degree may be substituted for one year of required experience.
- Knowledge of health care compliance policies, practices and systems.
- Ability to analyze and interpret data to identify trends.
- Ability to maintain detailed and accurate records; follow oral and written directions; prepare written agendas, transcribe minutes, and develop reports.
- Ability to conduct all necessary research, root analysis and trends to accurately identify complex issues.
- Ability to consistently meet compliance accuracy and timeline requirements according to regulatory requirements.

**Please review the full job description on our Career’s page**:
Pay: $80,428.00 - $120,642.00 per year

**Experience**:

- Compliance: 3 years (required)
- Healthcare: 3 years (required)

Ability to Commute:

- San Jose, CA 95119 (required)

Ability to Relocate:

- San Jose, CA 95119: Relocate before starting work (preferred)

Work Location: In person

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